Demyelinating disease of the central nervous system associated with Pembrolizumab treatment for metastatic melanoma

Mult Scler. 2019 Jun;25(7):1005-1008. doi: 10.1177/1352458518803724. Epub 2018 Oct 12.

Abstract

Immune checkpoint inhibitors are used in metastatic melanoma with good efficacy and safety profile. We report the first case of an inflammatory demyelinating disease of the central nervous system during treatment with Pembrolizumab and discuss the evidence in the literature supporting its causative role. The patient had a good clinical recovery after intravenous steroids, plasma exchange and discontinuation of Pembrolizumab. Due to the expected increase in the importance of immune checkpoint inhibitors in cancer treatment, it is important to be aware of neurological adverse events, as early treatment usually leads to good clinical responses.

Keywords: Demyelination; Pembrolizumab; immune checkpoint inhibitors; immunology.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antineoplastic Agents, Immunological / adverse effects*
  • Demyelinating Diseases / chemically induced*
  • Demyelinating Diseases / diagnosis*
  • Female
  • Humans
  • Melanoma / drug therapy*
  • Middle Aged
  • Neoplasm Metastasis
  • Skin Neoplasms / drug therapy*
  • White Matter / diagnostic imaging
  • White Matter / pathology*

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological
  • pembrolizumab